Active NPI
Tiffany Chesare Moore, DMD
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1609360320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34118
- Practice address
- 3030 LBJ Fwy Ste 1400
Dallas, TX 75234-2766 - Phone
- (972) 663-5301
- NPI assigned
- Jun 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 34118 | TX | Primary |
Addresses
Primary practice location
3030 LBJ Fwy Ste 1400
Dallas, TX 75234-2766
Mailing address
2411 Washington Ave Apt 110
Houston, TX 77007-6310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34118 | Other | PPO AND HMO CARRIERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34118 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1609360320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 WASHINGTON AVE APT 110",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770076310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 LBJ FWY STE 1400",
"city": "DALLAS",
"state": "TX",
"postal_code": "752342766",
"telephone_number": "972-663-5301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "TIFFANY",
"middle_name": "CHESARE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-16",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPO AND HMO CARRIERS",
"identifier": "34118",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.